胃噴門部GISTに対する単孔式LECSにおけるEndo GIATM Tri-StapleTM Radial Reloadの有用性

Usefulness of Endo GIATM Tri-StapleTM Radial Reload during single-incision laparoscopy endoscopy cooperative surgery for gastric submucosal tumor just below the cardia

◆要旨：噴門直下の胃粘膜下腫瘍に対するEndo GIA^TM Tri-Staple^TM Radial Reload（以下，RR）を使用した単孔式腹腔鏡・内視鏡合同胃局所切除（laparoscopy endoscopy cooperative surgery：以下，LECS）の手技について報告する．単孔式LECSで臍の創から挿入したlinear staplerで噴門近傍の腫瘍切除部位の閉鎖をすると，短軸方向での閉鎖が比較的難しく噴門狭窄の心配がある．RRを使用することで短軸方向での閉鎖が容易となり，狭窄のリスクを低減できる．またRRの挿入も単孔式アプローチでは容易であり，有用な選択肢のひとつと考えられた．

　We report a useful procedure in laparoscopy endoscopy cooperative surgery （LECS） for a gastric submucosal tumor located just below the cardia using Endo GIA^TM Tri-Staple^TM Radial Reload （RR）. In single-incision LECS, it is difficult to close the gastric wall defect along the short axis, when the opening is closed by linear staplers inserted through an umbilical incision. RR increases the ease of closing the opening along the short axis and reduces the risk of cardial stenosis. Besides, RR can be easily inserted through the umbilical incision in single-incision laparoscopic surgery; therefore, RR is considered to be a useful device.